Ayak Bileği İnversiyon Yaralanmalarında Erken Proprioseptif Eğitimin Reaksiyon Zamanı ve Denge Üzerine Etkisi

Abstract

ABSTRACT Yigit, B., The Effects of Early Proprioceptive Training on Reaction Time and Balance in Ankle Inversion Trauma. Institute of Health Sciences, Prostheses- Orthoses and Biomechani Program, Ph.D. Dissertation, Ankara, 2015.The aims of this study are to investigate the effects of early proprioceptive training on reaction time and balance on the first and second-degreeankle inversion trauma and to express the differences from classical treatment protocol. 35 participants were included from Istanbul Medipol University, Mega Hospital ComplexDepartment Orthopedics and Traumatology and Emergency in 72 hours after ankle inversion trauma. Participants were divided into two groups; physiotherapy (n=18) and control (n=17). According to inclusion criteria, to determine the foot as normal, and to determine acute instability, foot postur index and ankle ligament laxity test were used, respectivly. Demographic information and history of injury were recorded.Karlsson Score for determining improvement, Foot and Ankle Outcome Score for quality of life, Visual Analog Scale for pain, anthropometric measurement for edema, electronic goniometer for muscle strength, iPhone goniometer app for range of motion, heel rise test for endurance, eye opened and closed single leg balance test and star excursion balance test for static and dynamic balance, active and passive extremity matching test for joint position sense, Nelson reaction time test for reaction time and TAMPA Scale for kinesiophobia were used. Treatment protocol generally was consisting of RICE (rest, ice, compression, elevation) protocol, transcutaneous electrical nerve stimulation, stretching, strengthening, manual therapy, balance and walking training. Physiotherapy group was also treated with proprioceptive training. Treatment protocol performed twice a week during six weeks. Assessments were performed before treatment, at the end of third week and at the end of sixth week. During the study, edema, proprioceptive error ratios and reaction time were reduced at physiotherapy group by the third week and improvement continued at the end of treatment. It was determined that pain was almost completely reduced at the end of six week on control group (p<0.05). All other parameters had statistically significant differences in groups, but there were no differences found between groups (p>0.005). This study showed that early proprioceptive training has an effect on proprioception and reaction time without increasing symptoms with reducing edema in acute ankle inversion trauma. Key words: Acute phase functional rehabilitation, quality of life, anterior talofibular ligament, reaction time